Based on a UW question, so stop reading if you don't want to have the question ruined for you.
Old guy aspirates while supine and subsequently develops a pneumonia. Most likely lung site affected?
1. posterior segment RUL
2. basilar segment of RLL
3. segments of RML
I've always gone by what's in RR Path (standing/sitting = posterobasal RLL. supine = superior RLL. positioned on right-side = RML or posterior RUL).
Correct answer to this particular question in UW was posterior segment of RUL. I put RML. I get that the RUL is more dependent than the RML in the supine position (since the RML is more anteriorly positioned), but the bronchus going to the RML is still at a more-obtuse angle than the bronchus going to the RUL regardless of body position. Which to me means that any aspirated material is more likely to enter the RML than the RUL and thus, the only way the lobar pneumonia affects the RUL more than the RML is if the material erodes through the RML and into the RUL (i.e. the patient remains supine for an extended period of time) due to the RUL being more dependent than the RML.
Old guy aspirates while supine and subsequently develops a pneumonia. Most likely lung site affected?
1. posterior segment RUL
2. basilar segment of RLL
3. segments of RML
I've always gone by what's in RR Path (standing/sitting = posterobasal RLL. supine = superior RLL. positioned on right-side = RML or posterior RUL).
Correct answer to this particular question in UW was posterior segment of RUL. I put RML. I get that the RUL is more dependent than the RML in the supine position (since the RML is more anteriorly positioned), but the bronchus going to the RML is still at a more-obtuse angle than the bronchus going to the RUL regardless of body position. Which to me means that any aspirated material is more likely to enter the RML than the RUL and thus, the only way the lobar pneumonia affects the RUL more than the RML is if the material erodes through the RML and into the RUL (i.e. the patient remains supine for an extended period of time) due to the RUL being more dependent than the RML.
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